Merck Safety Reporting

You can report one or more Adverse Event(s) for each submission.

Investigator/Other’s Name

Enter the name of the Principal Investigator (PI)

Investigator/Other’s Email Address

Enter the email address for the PI and/or other team members as needed.
Multiple emails can be provided by adding a comma between each address.

Investigator/Other Case ID#

Include the IIS number and/or assigned protocol number.

Attachment(s)

Upload the MEDWATCH/CIOMS Global Safety Intake Form or similar form(s) for reporting the Adverse Event.
Maximum upload size is 35MB. File format includes ZIP, PDF, DOCX, DOC, PPT, PPTX, XLS, XLXS, JPEG, JPG and PNG.

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The adverse experience or product quality information you provide is shared with regulatory agencies, Merck subsidiaries worldwide, and business partners with whom we have contractual agreements. Any information that identifies the patient directly, such as the patient's initials or date of birth, will be handled confidentially and in line with Merck corporate policies and local regulations. You have a right of access to your personal data which we hold about you. For further details on Merck’s privacy policy, please visit: www.msdprivacy.com